Structural Heart Disease

Structural heart disease is an umbrella term for faults in the heart's valves, walls and chambers, as opposed to problems of the coronary arteries or the electrical system. It covers narrowed or leaking valves, holes between chambers and related defects.

The term has come into use because many of these faults can now be repaired through a catheter from the groin instead of open surgery. Which approach suits you depends on the exact defect, your age and your surgical risk, and is best decided by a team of cardiologists and surgeons together.

Symptoms

• Breathlessness on effort
• Tiredness and declining stamina
• Chest tightness or fainting on exertion, typical of severe aortic stenosis
• Palpitations
• Ankle swelling
• A heart murmur found on examination
• A stroke or mini-stroke at a young age, which may point to a hole between the upper chambers

Causes and risk factors

Causes differ by defect. Aortic stenosis usually results from age-related calcification or a two-leaflet aortic valve present from birth. Mitral regurgitation arises from floppy leaflets, or from stretching of the heart after a heart attack. Rheumatic fever remains a common cause of mitral stenosis in many regions. Atrial septal defects and a patent foramen ovale are present from birth. Leaks beside a previously implanted valve and an enlarged left atrial appendage in atrial fibrillation are also treated within this field.

How it is diagnosed

• Transthoracic echocardiography: The first test. It grades valve narrowing and leakage and measures chamber size.
• Transoesophageal echocardiography: A probe in the gullet gives close views of the mitral valve, septum and appendage, and guides many procedures.
• Cardiac CT: Measures the valve ring and the access arteries to plan TAVI and other catheter treatments.
• Bubble study: Saline contrast during echo detects a patent foramen ovale.
• Cardiac catheterisation: Checks the coronary arteries and pressures before intervention.

Treatment options

• Watchful follow-up: Mild and moderate valve disease is monitored with periodic echo. Intervention is timed to symptoms or early strain on the heart.
• Transcatheter aortic valve implantation (TAVI): A new aortic valve delivered through the groin artery, established for older and higher-risk patients and increasingly used at intermediate risk.
• Surgical valve repair or replacement: Still the preferred route for many younger patients and for most mitral repairs, with mechanical or tissue valves.
• Transcatheter edge-to-edge mitral repair: A clip reduces mitral leakage in people unsuitable for surgery.
• ASD and PFO closure: An umbrella-like device seals the hole. PFO closure is considered after an otherwise unexplained stroke in selected patients.
• Balloon mitral valvuloplasty: Opens a rheumatic mitral valve that is narrowed but not heavily calcified.
• Left atrial appendage closure: Reduces stroke risk in atrial fibrillation when anticoagulants cannot be taken.

When it is urgent

Fainting, chest pain on exertion, severe breathlessness, or sudden weakness or speech difficulty need emergency assessment locally. Fever lasting several days in someone with a valve problem or implanted valve also needs prompt medical review.

Travelling to Türkiye for treatment

These are planned procedures and well suited to a visit when you are stable. Send your echo report and images beforehand so the team can advise whether catheter or surgical treatment is realistic. Typical stays are 5 to 8 days for TAVI or device closure and 2 to 3 weeks for open surgery. You will need an echo and anticoagulant or antiplatelet supervision at home afterwards.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions